Developmental screening and testing

Health professionals who see infants and children should screen for (watch for early signs of) developmental disabilities at every well-child visit. Developmental problems can affect how a child can talk, move, concentrate, and/or socialize.

The American Academy of Pediatrics recommends developmental testing for children at ages 9-, 18-, and 30-months, with specific checks for autism at ages 18 months and 24 months.^{1, 2} The doctor will use developmental tests and then review your child's results. He or she will compare your child's abilities with the normal milestones of children of the same age.

Your child will be evaluated right away if the doctor discovers obvious signs of developmental delays, such as:

• No babbling, pointing, or other gestures by 12 months.
• Saying no single words by 16 months.
• Saying no two-word spontaneous phrases by 24 months, with the exception of repeating phrases (echolalia).
• Any loss of language or social skills at any age.

If there are no obvious signs of developmental delays or any unusual indications from the tests, most infants or children do not need further evaluation until the next well-child visit.

Children who have a sibling who has autism need continued monitoring. Along with the evaluations at well-child visits, these children should be tested for language delays, learning problems, poor socialization skills, and any symptoms that might suggest they have anxiety or depression.³ Sometimes a developmental pediatrician will do these tests.

When socialization, learning, or behavior problems develop in a person at any time or at any age, he or she should be evaluated.

Citations

1. Council on Children With Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee and Medical Home Initiatives for Children With Special Needs Project Advisory Committee (2006). Identifying infants and young children with developmental disorders in the medical home: An algorithm for developmental surveillance and screening. Pediatrics, 118(1): 405–420. [Erratum in Pediatrics, 118(4): 1808–1809.]
2. Johnson CP, et al. (2007). American Academy of Pediatrics clinical report: Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120(5): 1183–1215.
3. Filipek PA, et al. (2000). Practice parameter: Screening and diagnosis of autism: Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Child Neurology Society. Neurology, 55: 468–479.